USING A WEB-BASED PATIENT REPORTED OUTCOMES PROGRAM (MYPSYCKES) TO EXAMINE PATIENT SMOKING STATUS AND INTEREST IN CESSATION SUPPORT

Purpose: Cigarette smoking is more prevalent among individuals with serious mental illness than among the general population, and is a modifiable risk factor for early morbidity and mortality. Psychiatric patients, with proper support and interventions, can realize similar cessation rates to the general population. Growing evidence suggests that patients’ self-reported motivation to quit can be an effective entry point for follow-up.   In the current study, we examined questions related to smoking status and cessation support preferences in the outpatient setting.  

Method: Smoking screening questions were embedded into a web-based patient reported outcomes and decision support tool (MyPSYCKES) that was implemented in ten outpatient mental health clinics across New York State. A total of 767 patients used the decision support tool.  The NYSOMH team reviewed patients’ responses to questions concerning patients’ stage of motivation for smoking cessation and interest in additional support for quitting smoking, including quit tips, medications, support groups, and peer videos.   

Result: 38.6% (n=296) of patients indicated that they were current smokers, and of those, 50.9% (n=149) indicated that they were seriously thinking of quitting smoking (22.9% (n=67) within the next 30 days, 28.0% (n=82) within the next 6 months).   For the follow-up question about additional supports, 54.8% (n=68) of patients who were thinking of quitting expressed an interest in information and support to quit smoking, while 15.1% (n=19) of smokers who were not thinking of quitting (n=126) were also interested in getting cessation support. Among those requesting help (n=87), the most frequently requested support was tips to quit smoking (57.5% (n=50)), followed by information about quit medications (31.0% (n=27)), direct support from their clinical team (28.7% (n=25)), videos of other peers who have quit smoking (9.2% (n=8)), and other supports (14.9% (n=13)). 

Conclusion: Among patients’ self-reported smoking status, more than a third were active smokers, however a majority expressed an interest in receiving cessation information and help from their mental health clinic. Interestingly, among patients who initially stated they were not interested in quitting, a modest percentage expressed interest in smoking cessation support resources. These findings suggest that embedding smoking screening questions into a patient reported outcomes and decision support tool can be an effective way to identify active smokers and provide them with targeted support that is based on their preferences.